Please help with blood test results

Hi, just wondering if someone can help?

I've been suffering from fatigue, brain fog, dizziness etc. for a few years now. To begin with I was ok in the summer but always exhausted in the winter, and I was diagnosed as having S.A.D. For the last couple of years the fatigue has persisted through the summer, and a couple of weeks ago I was dismissed from my (new) job for being too slow (due to being too exhausted to work at the required speed).

I visited the doctor, was signed off work, and had a blood test. I made sure the doctor knew that underactive thyroid and pernicious anaemia both run in the family so she requested tests for these as well as all the usual taking my age into consideration (I'm 47).

I was told the result was normal and today I've obtained a copy of the results to check. I didn't know much about the test before but am now wondering if I need to request any more tests such as free T3?

My results are: Serum free T4 level (XaERr) = 12.6 pmol/L [9.0 - 24.0] and Serum TSH level (XaELV) = 2.09 mu/L [0.2 - 4.5]

I have another appointment with my doctor on the 25th (earliest appointment I could get with the same doctor) and would like to have as much information as possible so that I can't be 'fobbed off'.

Would really appreciate any help.

Thanks in advance.

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13 Replies

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  • Your TSH is far too high and your Free T4 is too low. So you need a levo dose increase.

    You want your TSH to be 1 or under it. It doesn't matter how low it goes as it is not relevant when taking thyroid hormone replacement.*

    You want your Free T4 to be in the upper quarter of the range.

    Edited to add - *doctors don't agree with this but they don't know a lot about the thyroid.

  • Thanks bluebug,

    I'm not actually on any meds at the moment, still trying to get a diagnosis. I was told by the surgery that my results are normal so I'm guessing I may have a bit of a battle to get a diagnosis. Any advice for getting the doctor to agree that my results are not normal and that I actually need some help?

  • Nope as far as your test results are concerned they are euthyroid e.g. normal thyroid function. The information I stated is only relevant if you are on thyroid hormone replacement.

    You should point out to your doctor that your symptoms could be a vitamin and/or iron deficiency.

    Common deficiencies are:

    1. Vitamin B12 and folate - these go together and you are having this checked.

    2. Vitamin D - if you work indoors and have been feeling ill for over a year so haven't gone out much then point out this out very clearly to your doctor and also state "it is like you are housebound."

    3. Iron - you want ferritin tested not just haemoglobin.

    In addition you want a full blood count to rule out problems with your red cells, white cells and platelets.

    If the doctor refuses to do them then you are going to have to pay for private testing for the items I've numbered. This is around £99 from Blue Horizons or Medichecks and you order them online.

  • I suggest you read the main thyroid uk org website and understand as much as possible about how the thyroid works - thyroiduk.org.uk/tuk/index....

    You may find even if your GP asks for you to have a free T3 test the lab will refuse to do it.

    Most people on here either have to do the test privately using Blue Horizons or Medichecks, or they have to be referred to an endo. However endos, like all specialists, can refuse to see you if they think the GP can deal with it.

    So I would read up, ask for a dose increase in levo, get the test results for PA back and then go from there.

  • Thanks, I'll take a look at the website. I'm not on any meds so no chance of getting an increased dose yet. Will get the free T3 test somehow even if I do have to go private, just hope it doesn't cost too much as I have no income at the moment but I'll find it somehow.

    I think my B12 is ok, Serum vitamin B12 level (XE2pf) = 465 ng/L [180.0 - 910.0] and Serum folate level (42U5.) = 12.6 ug/L?

  • Your vitamin B12 should be at least 500 and your folate should be halfway in the reference range to be optimal.

    As you aren't deficient the NHS won't treat you, and anyway the first course of treatment is prescribing you supplements which you can buy cheaper and better yourself instead of getting them on a prescription.

    The best brands tend to be Solgar and Jarrows. In the case of B12 you want lozenges that you place sublingually. In the case of folate you want a vitamin B complex to balance the B vitamins out. You can buy the supplements on Amazon as if you try to get them on the high street or in a pharmacist you are likely to be sold rubbish and told misinformation. Most health professionals whether they are doctors, nurses or pharmacists aren't taught about nutrition especially involving healthy people so come out with stuff that is really out of date.

  • I would start on these while trying to get your GP to test the rest I've mentioned.

  • Your tests are normal. Your thyroid clearly isn't the cause of your issues. Given your age, it could be menopausal?

    Speak to your GP again. They can arrange for hormone profile blood tests. These aren't always reliable but most GPS will test and diagnose based on symptoms rather than rely totally on tests.

  • Also get your GP to check for vitamin D deficiency. Very similar symptoms to thyroid issues.

  • Thank you.

    So the tests that have been done so far are:

    Serum C reactive protein level (XaINL), Thyroid function test (X77Wg), Serum iron tests (XE24q), Erythrocyte sedimentation rate (XE2m7), Liver function tests (X77WP), Serum calcium level (XE2q3), Urea and electrolytes (X77Wi), Full blood count(424..), Plasma fasting glucose level (44g1.), Serum lipid levels (XE2q7), Blood haematinic levels (XaDsm), and Gonadotrophin level (XE25H).

    Results of the Serum iron tests (XE24q) are: Serum iron level (X76tH) = 17.0 umol/L [10.0 - 28.0], Unsaturated iron binding capacity (XaEPM) = 43 umol/L [27.8 - 63.6], and percentage iron saturation (XaJm0) = 28% [15.0 - 40.0]. Is this within the range that it should be?

    Blood haematinic levels (XaDsm): Serum vitamin B12 level (XE2pf) = 465 ng/L [180.0 - 910.0] and Serum folate level (42U5.) = 12.6 ug/L So I need a B12 supplement but I'm not sure what the normal range is for the folate as all it says on the test is that levels above 5.4 do not suggest Folate deficiency. My folate is obviously above the lower level but I'm not sure if it's at the optimal level?

    So I need to get Vitamin D, iron ferritin, and hormone profile blood tests? Anything else? I have a needle phobia so would prefer to get it all out of the way in one go if possible. I know I'm a wimp.

    Will look for one of the B12 supplements you mentioned and start taking it while I wait for the remaining tests.

    Feel like I'm starting to make some progress now. Thank you.

  • I already have the b12 results so do I still need to wait till after the Vitamin D, iron ferritin, and hormone profile blood tests?

  • Not yet, I'm seeing the doctor again on Thursday (earliest appointment I could get with the same doctor) so will be making a request then.

  • without free t3 test and also

    ferritin

    folate

    b12

    vit d3

    its difficult but the usual reason for a lowish TSH and low Freet4 along with hypothyroid symptoms is CENTRAL or TERTIARY Hypothyroid as opposed to all your GP is thinking about is Primary Hypothyroid where the TSH rises higher

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